Digestive Diseases and Sciences最新文献

{"title":"Navigating the Zenith of Documentation at the Dawn of the AI Era.","authors":"Saeed Soleymanjahi, Durga Thakral, Daniel J Stein","doi":"10.1007/s10620-026-10133-2","DOIUrl":"10.1007/s10620-026-10133-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5307-5310"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Steroid Failure and Outcomes of Rescue Therapy in Severe ICI-Induced Colitis: A Multicenter Study from GETECCU.","authors":"Cristina Polo Cuadro, Marta Gascón Ruiz, Manuel Barreiro, Míriam Mañosa, Francisco Rodríguez Moranta, Yamile Zabana, Elena Céspedes Martínez, Ingrid Ordás, José Miranda Bautista, María José García, Irene García de la Filia Molina, Cristina Roig Ramos, Alexandra Ruiz Cerulla, José Xavier Segarra Ortega, Virginia Matallana Royo, G Esther Rodríguez González, Fernando Martínez de Juan, Noemí Manceñido Marcos, Lucía Madero Velázquez, Elena Betoré Glaría, Begoña Álvarez Herrero, Gerard Suris, Alejandro Garrido Marín, Eduard Brunet Mas, Inmaculada Alonso Abreu, Javier Santos Fernández, María Vaamonde Lorenzo, Cristina Almingol Crespo, Carla Folguera, Patricia Sanz Segura, Óscar Moralejo Lozano, Laura López Couceiro, Coral Tejido Sandoval, Raquel Mena Sánchez, Empar Sainz, Miquel Marquès Camí, Rocío Ferreiro Iglesias, Silvia Patricia Ortega Moya, Pablo Miles Wolfe García, Pere Borras Garriga, Belén Herreros Martínez, María Calvo, Santiago Frago Larramona, Pablo Ladrón Abia, Carla J Gargallo Puyuelo, Xavier Serra, Luis Menchén, Coral Rivas, Francisco Mesonero Gismero, Raquel Vicente Lidón, Ana Gutierrez, Santiago García López, Diego Casas Deza","doi":"10.1007/s10620-026-10118-1","DOIUrl":"10.1007/s10620-026-10118-1","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but are frequently associated with immune-mediated colitis (IMC), a potentially severe complication. However, evidence on treatment effectiveness and predictors of response is limited.</p><p><strong>Materials and methods: </strong>We conducted a multicenter, retrospective study promoted by GETECCU including adult patients with solid tumors who developed grade 3-4 IMC requiring hospitalization between 2014 and 2024. All patients received intravenous corticosteroids; those refractory to steroids could receive targeted therapies. Clinical symptoms were assessed using a modified partial Mayo score including abdominal pain, and endoscopic activity was evaluated with the UCEIS index. Treatment failure was defined as the need for rescue therapy, surgery, or death.</p><p><strong>Results: </strong>We included 211 patients (40% women, mean age 62 years). Corticosteroid response was achieved in 50.2% of cases. Non-responders had shorter time to IMC onset, prior outpatient steroid use, higher symptom severity, and more frequent moderate-to-severe endoscopic findings. Independent predictors of corticosteroid failure were prior oral corticosteroid use (OR 4.4), higher UCEIS score (OR 1.31), and higher modified Mayo score (OR 1.45). A total of 113 rescue therapies were administered, primarily infliximab, vedolizumab, or ustekinumab, with overall effectiveness rates of 65-72%. Clinical severity was the only factor associated with reduced response to rescue therapy.</p><p><strong>Conclusion: </strong>Corticosteroid efficacy in severe IMC is limited. Clinical symptom severity and endoscopic ulcerations predict poor response to corticosteroids, while symptom severity also influences outcomes of biologic rescue therapy. Early identification of high-risk patients may improve treatment strategies.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5754-5763"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Nitric Oxide Alters Stem Cell Evolution Over Space and Time-Implications for Colitis-Associated Carcinogenesis.","authors":"Dmitriy Vladimirovich Karpenko","doi":"10.1007/s10620-026-10150-1","DOIUrl":"10.1007/s10620-026-10150-1","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5315-5317"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bile Acid Malabsorption Panel in Patients with Treated Neuroendocrine Tumors.","authors":"Ayah Matar, Thorvardur R Halfdanarson, Mohamad B Sonbol, Timothy J Hobday, Patrick W McGarrah, Morgan C Miller, Rachel A Eiring, Leslie J Donato, Michael Camilleri","doi":"10.1007/s10620-026-10127-0","DOIUrl":"10.1007/s10620-026-10127-0","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with neuroendocrine tumors experience diarrhea due to bioactive products of neuroendocrine tumors, bile acid malabsorption, or small bowel resection. We previously validated a bile acid malabsorption panel based on single stool primary bile acid (> 10%) and fasting serum C4 (> 52.5 ng/mL) to diagnose bile acid malabsorption.</p><p><strong>Methods: </strong>Our aim in this study was to audit diagnosis of bile acid malabsorption using the bile acid malabsorption panel in patients with treated neuroendocrine tumors compared with patients with functional diarrhea.</p><p><strong>Results: </strong>Bile acid malabsorption was identified in 14/23 (61%) patients with neuroendocrine tumors based on combined C4 and single stool primary bile acid. Bile acid malabsorption was more prevalent in patients with NET than in patients with functional diarrhea as demonstrated by significantly higher primary bile acids and serum C4.</p><p><strong>Conclusion: </strong>The bile acid malabsorption panel is a feasible convenient test to positively diagnose bile acid malabsorption in patients with neuroendocrine tumors.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5981-5985"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Age on Inflammatory Bowel Disease Presentation and Management in Older Adults.","authors":"Christina Sisliyan, Jerome Tomas Andres, Kian Keyashian","doi":"10.1007/s10620-026-10161-y","DOIUrl":"10.1007/s10620-026-10161-y","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is facing a demographic shift with a growing number of older adults.Advanced age affects treatment patterns and as a result older IBD patients often face conservative treatment regimens. Complications associated with aging such as frailty, comorbidities, and polypharmacy pose challenges in management.</p><p><strong>Aim: </strong>This review critically examines the influence of aging on IBD presentation and evaluates evolving treatment frameworks in older adults. It further explores the interplay of key age-related factors and their combined impact on therapeutic decision-making, clinical outcomes, and treatment-related adverse events.</p><p><strong>Methods: </strong>Studies for this narrative review were collected from Pubmed, Embase, and Web of Science. Studies addressing IBD presentation, disease outcomes, and treatment patterns in older versus younger adults were considered. Additionally, studies investigating age-related factors such as, frailty, comorbidity, and polypharmacy on treatment tolerance were considered.</p><p><strong>Results: </strong>Disease activity and disease-related complications do not wane in severity with advanced age. Older IBD patients face overutilization of corticosteroids and reduced use of advanced therapies despite emerging data showing that certain advanced therapies such as, vedolizumab and ustekinumab, are well tolerated in this age group. Advanced therapies are often deferred due to age. However, our review highlights that frailty, comorbidity, and polypharmacy better predict treatment tolerability than chronologic age.</p><p><strong>Conclusion: </strong>IBD management should shift from age-based assumptions to risk-stratified care. Our review found thatage alone did not increase most adverse events related to advanced therapy usage. This calls for a paradigm shift in treatment approaches for older adults with IBD.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"6053-6063"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albumin in the Management of Hepatorenal Syndrome-Acute Kidney Injury: Is There Ever Too Much?","authors":"Nicodemus Ong, Florence Wong","doi":"10.1007/s10620-026-10169-4","DOIUrl":"10.1007/s10620-026-10169-4","url":null,"abstract":"<p><strong>Background: </strong>Concerns about albumin causing respiratory failure in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI) have caused unease with excess albumin use in these patients.</p><p><strong>Aim: </strong>To assess the outcomes of patients with HRS-AKI who received varying daily albumin doses.</p><p><strong>Methods: </strong>Retrospective study of inpatients with HRS-AKI between Jan 2020 and Apr 2023 collected clinical and laboratory data, AKI treatment, and hospital course with 6-month follow-up. 3 groups of patients such as no albumin, standard albumin (≤ 50 g/day), and high albumin (> 50 g/day) were compared.</p><p><strong>Results: </strong>159 AKI episodes were diagnosed in 149 patients (age 60 ± 11 years; male: 63%; MELD-Na: 29 ± 7). 16 AKI episodes received no albumin. Standard and high albumin patients had higher MELD score (p = 0.007) and higher Child-Pugh score (p = 0.057) compared to no albumin group. Standard albumin patients received 40 ± 10 g/day for 6.3 ± 6.5 days, versus 66 ± 14 g/day for 8.5 ± 6.7 days (p < 0.001 and p = 0.055, respectively) in high albumin group. 44 of 54 AKI episodes in high albumin patients had infection as an AKI precipitant (p < 0.001), 67% had stage 3 AKI (p = 0.002 vs. the other 2 groups) with peak creatinine at 403 ± 173 µmol/L, associated with higher rate of AKI progression (p = 0.01), with similar duration of hospital stay compared to the other 2 groups. Respiratory failure occurred in 2 patients in each albumin group related to pneumonia and aspiration. Survival at 6 months was not significantly reduced in the albumin groups (p = 0.141).</p><p><strong>Conclusion: </strong>Patients with severe liver dysfunction with HRS-AKI triggered by infection receiving more than recommended albumin dose did not have a more adverse outcome compared to standard albumin dose.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5880-5889"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Endoscopic Retrograde Cholangiopancreatography for Managing Central Bile Duct Injury in Traumatic Liver Rupture: A Retrospective Cohort Study.","authors":"Peng Gao, Weiya Zhang, Hui Qin, Yijiang Ni","doi":"10.1007/s10620-026-10166-7","DOIUrl":"10.1007/s10620-026-10166-7","url":null,"abstract":"<p><strong>Background: </strong>Traumatic liver rupture with central bile duct injury (CBDI) presents a complex clinical challenge associated with high morbidity. The role and optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) in this setting remain controversial. This study aimed to compare the clinical outcomes of early versus delayed/on-demand ERCP in managing such injuries.</p><p><strong>Materials and methods: </strong>This retrospective cohort study (2020-2024) included 120 trauma patients with liver rupture and confirmed CBDI at The Second People's Hospital of Changzhou Trauma Center. Patients were divided into early ERCP (≤ 72 h, n = 62) and delayed/on-demand ERCP (> 72 h or for complications, n = 58). Primary outcome was abdominal infection incidence; secondary outcomes included biloma, enteral nutrition (EN) establishment, length of hospital stay (LOS), and unplanned re-interventions.</p><p><strong>Results: </strong>Compared to the delayed/on-demand group, the early ERCP group had significantly lower rates of abdominal infection (19.4% vs. 36.2%, P = 0.04) and biloma formation (8.1% vs. 22.4%, P = 0.03). They also achieved earlier EN initiation (median 3.0 vs. 6.0 days, P < 0.001) and target (median 7.0 vs. 12.0 days, P < 0.001), and had shorter LOS (24.2 ± 8.5 days vs. 32.5 ± 11.0 days, P < 0.001). No significant difference in post-ERCP pancreatitis was observed (P = 0.68). Multivariate analysis identified delayed ERCP (OR 2.58, 95%CI 1.30-5.12) and concomitant bowel injury (OR 3.05, 95%CI 1.42-6.55) as independent risk factors for abdominal infection.</p><p><strong>Conclusions: </strong>Early ERCP (≤ 72 h) is an effective management strategy for traumatic liver rupture with CBDI. It significantly reduces infectious complications, facilitates early EN, and shortens hospital stay, representing an optimized multidisciplinary approach for these complex patients.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5968-5978"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronotherapy in Inflammatory Bowel Disease: Biological Rationale, Human Evidence, and a Clinical Implementation Framework.","authors":"Khaled H Husain, Hira Khan, Bianca Thakkar, Musa Bungish, Haleh Vaziri","doi":"10.1007/s10620-026-10196-1","DOIUrl":"10.1007/s10620-026-10196-1","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic condition driven by a dysregulated immune response to the gut microbiome in genetically susceptible individuals. This process may be influenced by the circadian rhythm, the body's internal 24-h clock that coordinates physiology with the day-night cycle. Disruption of this rhythm, whether from behavior or intrinsic dysfunction, can disturb intestinal homeostasis and promote inflammation. Chronotherapy applies this concept clinically by aligning medical treatment with circadian timing to optimize efficacy and reduce adverse effects. There is growing evidence suggesting the importance of this approach for drug metabolism, immune activity, and symptom patterns, offering a new dimension of personalization beyond medication choice alone. This review summarizes the biological links between circadian regulation and intestinal inflammation, highlights emerging human data supporting time-based treatment strategies, and proposes a practical framework for integrating chronotherapy into routine IBD management. By considering when a therapy is delivered in addition to what therapy should be used, clinicians may enhance treatment response, limit toxicity, and improve overall disease control.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"6100-6112"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"11.5-Fr Large-Bore Plastic Stents Versus Fully Covered Self-Expandable Metallic Stents for the Management of Preoperative Endoscopic Biliary Obstruction in Pancreatic Cancer: A Multicenter Retrospective Cohort Study.","authors":"Akinori Maruta, Takuya Koizumi, Kota Shimojo, Yosuke Ohashi, Shota Iwata, Hironao Ichikawa, Naoki Mita, Yuhei Iwasa, Mitsuru Okuno, Shinya Uemura, Keisuke Iwata, Tsuyoshi Mukai, Takuji Iwashita, Masahito Shimizu","doi":"10.1007/s10620-026-10136-z","DOIUrl":"10.1007/s10620-026-10136-z","url":null,"abstract":"<p><strong>Background: </strong>Self-expandable metallic stents (SEMSs) are recommended for preoperative biliary drainage in patients with pancreatic cancer. However, they are associated with a relatively high incidence of non-recurrent biliary obstruction (RBO) adverse events (AEs), such as pancreatitis and cholecystitis. The 11.5-Fr large-bore plastic stent (LBPS) is a newly developed stent with a larger diameter than conventional plastic stents. The aim of the present study was to compare the clinical outcomes of LBPS and SEMS in preoperative biliary drainage for pancreatic cancer.</p><p><strong>Methods: </strong>We retrospectively evaluated 80 patients who underwent preoperative biliary drainage for pancreatic cancer between January 2011 and December 2025. Patients were divided into the LBPS and SEMS groups according to the stent placed.</p><p><strong>Results: </strong>RBO occurred in 20.0% and 25.0% of patients in the LBPS and SEMS groups, respectively, with no significant difference in the time to RBO between the groups. Pancreatitis and cholecystitis were observed in 0% versus 18.3%, and 0% versus 8.3% of patients in the LBPS and SEMS groups, respectively.</p><p><strong>Conclusion: </strong>The 11.5-Fr LBPS demonstrated patency comparable to that of SEMS and was associated with a low incidence of non-RBO AEs. These findings should be interpreted cautiously and require confirmation in larger prospective studies.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5699-5710"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Quality of Life and Symptom Severity Correlate with Celiac Disease Serology in Adolescents?","authors":"Priyanka V Chugh, Lydia Ramharack, Kat Adams, Lynne Allen-Taylor, Patricia Bierly, Kara Feigenbaum, Janel Steinhoff, Ritu Verma, Arunjot Singh, Lisa M Fahey","doi":"10.1007/s10620-026-10128-z","DOIUrl":"10.1007/s10620-026-10128-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescents with a new diagnosis of celiac disease (CeD) face challenges navigating social relationships while also managing symptoms and the gluten-free diet. The purpose of this study is to evaluate the relationship between quality of life (QoL), symptoms, and CeD serology in adolescents with CeD.</p><p><strong>Methods: </strong>Cross-sectional survey study of adolescent patients (13-18 years old) within one year of biopsy-proven diagnosis of symptomatic CeD. Participants completed the PedsQL questionnaire, a health-related QoL assessment, and the Celiac Symptom Index (CSI), a measure of CeD-related symptoms. Tissue transglutaminase IgA (tTG-IgA) was used as a measure of disease activity. Means, mean difference, t test, and point biserial correlations were computed to assess the association of tTG-IgA with CSI and PedsQL scores.</p><p><strong>Results: </strong>Fifty-four adolescents and parents/guardians were surveyed. Thirty-seven had abnormal tTG-IgA and were compared to those with normal tTG-IgA. There were significant differences in overall PedsQL scores (84.75 vs 77.03, r = -0.28, p = 0.05), social subscores (95.42 vs 88.59, r = 0.24, p = 0.02), emotional subscores (80.83 vs 66.62, r =- 0.31, p = 0.03), and school functioning subscores (81.25 vs 68.89, r =- 0.36, p = 0.01). There was no significant relationship between tTG-IgA and the physical subscore or CSI score. Females report higher CSI scores and lower PedsQL scores. Older age at diagnosis was associated with lower PedsQL scores.</p><p><strong>Discussion: </strong>Adolescents with abnormal tTG-IgA serology had lower QoL scores that were unrelated to measures of physical symptoms (CSI and physical subscore of PedsQL). This suggests more complex drivers of QoL that are not related to physical symptoms but are still associated with persistently elevated serology.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5691-5698"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}